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I just listened to an excellent Webinar given by Dr. Russ Barkley, “Early Morning Functioning in Children and Adolescents with ADHD”

(Through the CHADD.org and sponsored by an educational grant from Ironshore Pharmaceuticals)

Dr. Barkley has been one of the most resourceful researcher, clinician, educator, and mentor for professionals (physicians and mental health professionals), but also for families with individuals with ADHD (from preschoolers to adults).

During the webinar, Dr. Barkley talked about one aspect of the life of families with one person with ADHD that has not been given enough attention from the clinical and professional point of view: What happens in the lives of families with children (adolescents, and adults) with ADHD when they first wake up for a school day, when they have to get dressed, eat breakfast, have all their materials together for school, and get to their transportation on time to go to school?

Dr. Barkley demonstrated with research data that even when children (and adolescents) take proper medications for ADHD, at the early hours of the day they still do not have the therapeutic effect of the medication that would have a positive effect for decreasing their symptoms for the rest of the day. As a consequence, it is during the first couple of hours of the day that children have to use the skills that they have the most difficulty with that they end up having significant behavioral problems and these affect the whole family (parents and siblings

Dr. Barkley described examples of difficulties in the morning that are associated with executive functions (time management, for instance), and how these create tremendous stress for the family with conflict with parents, less effective discipline displayed, more defiance from children, danger of children even getting hurt (they are more prone to accidents), among other possible stressful situations that usually happen at home before the family leaves for a day at school and at work.

As Dr. Barkley stated clearly, the topic of early morning functioning impairments for children and the impact of such difficulties on the whole family is certainly something that needs to be discussed with all physicians who diagnose and treat ADHD.

In addition, mental health professionals also have to ask parents questions about the effect of treatment (medical and behavioral) not only on school functioning, but also at other times of the day, such as morning routines. They also need to help parents develop behavioral management programs for their children to address these very important hours of the day. Dr. Barkley mentioned that there is a correlation between early morning stress and conflict with the family and lower disposition to learn later on at school. In addition, when there is stress in the morning, children are less likely to have breakfast, which affects their disposition to learning as well.

Thank you, Dr. Barkley, for such wonderful Seminar, and for endless contribution to the families with individuals with ADHD and to helping professionals learn more on how to help diagnose and treat ADHD and their families. And thank you CHADD.org for providing the learning opportunity to professionals and families. Vera Joffe, Ph.D. ABPP (Board Certified in Clinical Child and Adolescent Psychology), Licensed Psychologist (FL, NY), PCIT Certified Therapist (PICT International), www.verajoffe.com